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href=\u0022https:\/\/www.bmj.com\/sites\/default\/files\/advagg_css\/css__GkPSKUkdJ2bzIT9BLdob0bbh88SFHg9JxcNgbdHlbDc__qYTxeL-KKGqFiuvt1Pd7tJWAZkcDxAZN7jCKDHxZcE0__b2e6faiQ_UWIrIhhy-1_GBi9M1f1xMsmWzx8NA2PKwk.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-jnl-bmj-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n \n \n \n \u003Cdiv class=\u0022pane-content\u0022\u003E\n \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 data-highwire-cite-ref-tooltip-instance=\u0022highwire_reflinks_tooltip\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022contributors\u0022\u003E\u003Col class=\u0022contributor-list\u0022 id=\u0022contrib-group-1\u0022\u003E\u003Cli class=\u0022last\u0022 id=\u0022contrib-1\u0022\u003E\u003Cspan class=\u0022name\u0022\u003EAnna Sayburn\u003C\/span\u003E\u003C\/li\u003E\u003C\/ol\u003E\u003Col class=\u0022affiliation-list\u0022\u003E\u003Cli class=\u0022aff\u0022\u003E\u003Ca id=\u0022aff-1\u0022 name=\u0022aff-1\u0022\u003E\u003C\/a\u003E\u003Caddress\u003ELondon\u003C\/address\u003E\u003C\/li\u003E\u003C\/ol\u003E\u003C\/div\u003E\u003Cp id=\u0022p-2\u0022\u003EThe World Health Organization (WHO) is to coordinate an international study of treatments for covid-19 that will focus on four potential treatment strategies.\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003ETedros Ghebreyesus, WHO director general, said on 18 March that the SOLIDARITY trial was a response to fears that \u201cmultiple small trials with different methodologies may not give us the clear, strong evidence we need about which treatments help to save lives.\u201d\u003Ca id=\u0022xref-ref-1-1\u0022 class=\u0022xref-bibr\u0022 href=\u0022#ref-1\u0022\u003E1\u003C\/a\u003E\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EThe trial \u201cis designed to generate the robust data we need, to show which treatments are the most effective,\u201d he said. It will also be designed to put minimal burden on over-stretched hospitals.\u003C\/p\u003E\u003Cp id=\u0022p-5\u0022\u003EThe study will focus on four treatment options\u003Ca id=\u0022xref-ref-2-1\u0022 class=\u0022xref-bibr\u0022 href=\u0022#ref-2\u0022\u003E2\u003C\/a\u003E: the novel antiviral drug remdesivir, developed by Gilead in response to Ebola; lopinavir and ritonavir, antiretroviral drugs used against HIV; lopinavir and ritonavir in combination with the immune system regulator interferon \u03b2; the antimalarial drug chloroquine, which has reportedly been effective in China. The drugs and combinations will be tested against standard care, which is supportive treatment with supplementary oxygen and respiratory support as required.\u003C\/p\u003E\u003Cp id=\u0022p-6\u0022\u003EOn 13 March a consultation document for WHO\u2019s Research and Development advisory group for covid-19 research reported: \u201cThe expert panel recommended the direct-acting antiviral agent remdesivir and the protease inhibitor lopinavir\/ritonavir for evaluation in randomized clinical trials.\u201d \u003C\/p\u003E\u003Cp id=\u0022p-7\u0022\u003E\u201cAt the time [27 January], there was insufficient evidence to support chloroquine\u2019s further investigation. However, chloroquine has received significant attention in countries as a potentially useful prophylactic and curative agent, prompting the need to examine emerging evidence to inform a decision on its potential role.\u201d\u003Ca id=\u0022xref-ref-3-1\u0022 class=\u0022xref-bibr\u0022 href=\u0022#ref-3\u0022\u003E3\u003C\/a\u003E\u003C\/p\u003E\u003Cp id=\u0022p-8\u0022\u003ECountries reported to be taking part in SOLIDARITY are Argentina, Bahrain, Canada, France, Iran, Norway, South Africa, Spain, Switzerland, and Thailand. WHO said that the trial would be simple to enter, with supporting information and registration documents expected to be published this week.\u003C\/p\u003E\u003Cp id=\u0022p-9\u0022\u003EEuropean hospitals are also being invited to take part in a similar trial, Discovery, coordinated by the French research institution INSERM.\u003Ca id=\u0022xref-ref-4-1\u0022 class=\u0022xref-bibr\u0022 href=\u0022#ref-4\u0022\u003E4\u003C\/a\u003E The trial organisers plan to include 3200 patients from Belgium, France, Germany, Luxembourg, the Netherlands, Spain, Sweden, and the UK. It will begin with five French hospitals and then invite up to 20 other European institutions to join the trial and will study the same drugs and drug combinations as the WHO trial. It will be randomised but open label and will assess outcomes at 15 days.\u003C\/p\u003E\u003Cp id=\u0022p-10\u0022\u003ELead researcher Florence Ader, from the Infectious and Tropical Diseases Department of the Croix-Rousse Hospital of Lyon University Hospital and researcher at the CIRI International Research Centre in Infectiology, said: \u201cThe great strength of this trial is its adaptive nature. This means that ineffective experimental treatments can very quickly be dropped and replaced by other molecules that emerge from research efforts. We will therefore be able to make changes in real time, in line with the most recent scientific data, in order to find the best treatment for our patients.\u201d\u003C\/p\u003E\u003Cdiv class=\u0022license\u0022 id=\u0022license-1\u0022\u003E\u003Cp id=\u0022p-1\u0022\u003EThis article is made freely available for use in accordance with BMJ\u0027s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.\u003C\/p\u003E\u003Cspan class=\u0022ali-license-ref\u0022\u003E\u003Ca href=\u0022https:\/\/bmj.com\/coronavirus\/usage\u0022 rel=\u0022license\u0022\u003Ehttps:\/\/bmj.com\/coronavirus\/usage\u003C\/a\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cdiv class=\u0022section ref-list\u0022 id=\u0022ref-list-1\u0022\u003E\u003Ch2\u003EReferences\u003C\/h2\u003E\u003Col class=\u0022cit-list\u0022\u003E\u003Cli\u003E\u003Ca class=\u0022rev-xref-ref\u0022 href=\u0022#xref-ref-1-1\u0022 title=\u0022View reference 1 in text\u0022 id=\u0022ref-1\u0022\u003E\u21b5\u003C\/a\u003E\u003Cdiv class=\u0022cit ref-cit ref-web\u0022 id=\u0022cit-368.mar24_11.m1206.1\u0022\u003E\u003Cdiv class=\u0022cit-metadata unstructured\u0022\u003EWorld Health Organization. WHO Director-General\u2019s opening remarks at the media briefing on COVID-19. 18 March 2020. \u003Ca href=\u0022https:\/\/www.who.int\/dg\/speeches\/detail\/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19-18-march-2020\u0022\u003Ehttps:\/\/www.who.int\/dg\/speeches\/detail\/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19-18-march-2020\u003C\/a\u003E\u003C\/div\u003E\u003Cdiv class=\u0022cit-extra\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/li\u003E\u003Cli\u003E\u003Ca class=\u0022rev-xref-ref\u0022 href=\u0022#xref-ref-2-1\u0022 title=\u0022View reference 2 in text\u0022 id=\u0022ref-2\u0022\u003E\u21b5\u003C\/a\u003E\u003Cdiv class=\u0022cit ref-cit ref-web\u0022 id=\u0022cit-368.mar24_11.m1206.2\u0022\u003E\u003Cdiv class=\u0022cit-metadata unstructured\u0022\u003EWorld Health Organization. Thailand joins the WHO \u201cSolidarity Trial\u201d: global testing of effective treatments of COVID-19 across 8 countries \u2013 an aggressive effort to save lives from the pandemic (press release), 20 March 2020. \u003Ca href=\u0022https:\/\/www.who.int\/thailand\/news\/detail\/20-03-2020-thailand-joins-the-who-solidarity-trial-global-testing-of-effective-treatments-of-covid-19-across-8-countries-an-aggressive-effort-to-save-lives-from-the-pandemic\u0022\u003Ehttps:\/\/www.who.int\/thailand\/news\/detail\/20-03-2020-thailand-joins-the-who-solidarity-trial-global-testing-of-effective-treatments-of-covid-19-across-8-countries-an-aggressive-effort-to-save-lives-from-the-pandemic\u003C\/a\u003E\u003C\/div\u003E\u003Cdiv class=\u0022cit-extra\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/li\u003E\u003Cli\u003E\u003Ca class=\u0022rev-xref-ref\u0022 href=\u0022#xref-ref-3-1\u0022 title=\u0022View reference 3 in text\u0022 id=\u0022ref-3\u0022\u003E\u21b5\u003C\/a\u003E\u003Cdiv class=\u0022cit ref-cit ref-web\u0022 id=\u0022cit-368.mar24_11.m1206.3\u0022\u003E\u003Cdiv class=\u0022cit-metadata unstructured\u0022\u003EWorld Health Organization. R\u0026amp;D Blueprint COVID-1 Informal consultation on the potential role of chloroquine in the clinical management of COVID 19 infection. 13 March 2020. \u003Ca href=\u0022https:\/\/www.who.int\/blueprint\/priority-diseases\/key-action\/RD-Blueprint-expert-group-on-CQ-call-Mar-13-2020.pdf?ua=1\u0022\u003Ehttps:\/\/www.who.int\/blueprint\/priority-diseases\/key-action\/RD-Blueprint-expert-group-on-CQ-call-Mar-13-2020.pdf?ua=1\u003C\/a\u003E\u003C\/div\u003E\u003Cdiv class=\u0022cit-extra\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/li\u003E\u003Cli\u003E\u003Ca class=\u0022rev-xref-ref\u0022 href=\u0022#xref-ref-4-1\u0022 title=\u0022View reference 4 in text\u0022 id=\u0022ref-4\u0022\u003E\u21b5\u003C\/a\u003E\u003Cdiv class=\u0022cit ref-cit ref-web\u0022 id=\u0022cit-368.mar24_11.m1206.4\u0022\u003E\u003Cdiv class=\u0022cit-metadata unstructured\u0022\u003EINSERM. Launch of a European clinical trial against covid-19. 22 March 2020. \u003Ca href=\u0022https:\/\/presse.inserm.fr\/en\/launch-of-a-european-clinical-trial-against-covid-19\/38737\/\u0022\u003Ehttps:\/\/presse.inserm.fr\/en\/launch-of-a-european-clinical-trial-against-covid-19\/38737\/\u003C\/a\u003E\u003C\/div\u003E\u003Cdiv class=\u0022cit-extra\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/li\u003E\u003C\/ol\u003E\u003C\/div\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022https:\/\/www.bmj.com\/content\/368\/bmj.m1206.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022\u003EView Abstract\u003C\/a\u003E\u003C\/div\u003E \u003C\/div\u003E\n\n \n \u003C\/div\u003E\n\u003C\/div\u003E\n \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript src=\u0022https:\/\/www.bmj.com\/sites\/default\/files\/js\/js_am8GAfrhW3uXc7HVCmqF3MltMmNunvhyJ6MM_6EffRE.js\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}